Focus on hospitals, DHB funding

Fixing hospitals, enabling access to care and addressing New Zealand's ageing population were Health Minister David Clark's priorities in yesterday's Budget.

Health took the lion's share of spending, with a $3.2 billion funding boost, meaning 20 cents in every tax dollar is spent on health.

While health spending is yet to reach the dizzy heights Labour promised during the election campaign, the Budget extended free GP visits for under-14s, set aside $750 million of new capital expenditure on hospitals, and granted district health boards an additional $2 billion in operational expenditure.

"Hospitals have been underfunded for too long. Staff have been put under pressure," Dr Clark told the Otago Daily Times.

"They have done a wonderful job in the circumstances but they can only be stretched so far, especially as we have a growing and ageing population and we need to get real about the fact that costs more in terms of delivering more services to more people."

A major investment in primary care would mean children aged under 14 could be seen by a GP free, and many community service card holders will have their fees reduced.

"Around 56,000 13-year-olds will benefit from that, and for over 500,000 community service card holders doctor's visits will be $20-$30 cheaper," Dr Clark said.

"That should keep people out of hospital, as they will be able to be seen immediately rather than turning up at emergency departments."

Dr Clark said DHBs would be expected to carry out all deferred maintenance so their buildings would be safe.

He also expected the 20 DHBs - which are collectively running deficits of about $190 million - to return to break-even now additional funding was in place.

"I am expecting a reversal in the number of DHBs which are running deficits," Dr Clark said.

"I don't expect all those deficits to disappear in one year, but I do expect that we will see better financial management as we see more realistic funding amounts given to DHBs."

Dr Clark said he expected some of that new funding would go on mental health services, but new initiatives were being kept to a minimum until the inquiry into mental health and addiction services had completed its work.

"Being able to afford going to a GP will help, though, as that is often the first point of contact before moving on to specialist services . . . there will be more after the inquiry reports back."

National health spokesman Michael Woodhouse said Labour's health plans were disappointing, and its hike to core funding for DHBs was less than the increase the last Budget allocated.

"While they are trumpeting their numbers, it's less than we spent, and less than we would have spent this time," he said.

Royal New Zealand College of GPs president Tim Malloy said the 2016 New Zealand Health Survey showed more than 500,000 people chose not to see a GP because of cost, and time needed to be taken to get the solution right.

"We have seen evidence of this with many people turning up to hospital emergency departments because they can't afford $40-$70 to see their GP. This is a sign of a health system that's not working well," he said.

"Simply reducing GP fees won't necessarily make GPs more accessible - in fact it might create an unmanageable peak in demand, which the current workforce might not be able to match."

The Association of Salaried Medical Specialists said the Budget would ease some of the strain on the health sector, but there was a long way to go yet.

"It's difficult at this stage to assess how district health boards have fared under the Budget," director of policy and research Lyndon Keene said.

"On the figures available they appear to have received sufficient funding to maintain their current levels of service, but we need to analyse the figures further to fully understand the implications.

"It means that the current pressures facing hospital staff will continue this year, however."